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Official Description

Inguinofemoral lymphadenectomy, superficial, including Cloquet's node (separate procedure)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

A superficial inguinofemoral lymphadenectomy, as described by CPT® Code 38760, is a surgical procedure that involves the removal of lymph nodes located in the inguinal and femoral regions, specifically including Cloquet's node. Cloquet's node is a significant lymph node situated in the deep inguinal area, acting as a transitional point between the inguinal and iliac regions. This procedure is categorized as a separate procedure, indicating that it is performed independently and not as part of a more extensive surgical intervention. The surgical approach begins with an incision made parallel to the inguinofemoral ligament, which is carefully extended down to the layer known as Camper's fascia. During the operation, skin flaps are elevated while ensuring that they are separated from the underlying fat pad, allowing for better access to the deeper tissues. The dissection continues at the superior aspect of the inguinal region, where Cloquet's node is identified and excised. A frozen section analysis may be performed on this node to assess for malignancy. The procedure further involves mobilizing the fat pad that contains the nodal tissue down to the inferior margin of the inguinal ligament, followed by dissection into the femoral triangle. The cribriform fascia is then opened, and the nodal tissue over the common femoral vein is meticulously freed. Ultimately, the inguinofemoral nodal tissue is removed as a single specimen, ensuring that all relevant lymphatic tissue is excised for pathological evaluation.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure of superficial inguinofemoral lymphadenectomy (CPT® Code 38760) is indicated for the following conditions:

  • Malignancy Evaluation: This procedure is performed to evaluate the presence of malignancy in the inguinal lymph nodes, particularly when there is a suspicion of cancer spread from nearby structures.
  • Diagnosis of Lymphatic Disorders: It may be indicated for diagnosing various lymphatic disorders that affect the inguinal region.
  • Management of Lymphadenopathy: The procedure is also indicated for the management of lymphadenopathy in the inguinal area, especially when associated with malignancy.

2. Procedure

The procedure of superficial inguinofemoral lymphadenectomy involves several critical steps:

  • Step 1: An incision is made parallel to the inguinal ligament, which allows access to the underlying tissues. This incision is carefully extended down to Camper's fascia, a layer of fat that lies beneath the skin.
  • Step 2: Skin flaps are elevated, and during this process, the flaps are separated from the underlying fat pad. This step is crucial for exposing the deeper structures without causing unnecessary damage to surrounding tissues.
  • Step 3: The surgeon dissects the deep tissues at the superior aspect of the inguinal region to locate Cloquet's node. This node is identified and excised, and a frozen section may be performed to assess for malignancy.
  • Step 4: The fat pad containing the nodal tissue is then elevated and mobilized down to the inferior margin of the inguinal ligament, ensuring that all relevant lymphatic tissue is accessible for removal.
  • Step 5: Dissection continues into the femoral triangle, where the cribriform fascia is opened to further expose the nodal tissue.
  • Step 6: Once the nodal tissue over the common femoral vein is completely freed, the inguinofemoral nodal tissue is removed as a single specimen, which is essential for pathological evaluation.

3. Post-Procedure

After the superficial inguinofemoral lymphadenectomy, patients typically require monitoring for any complications related to the surgery. Expected recovery includes managing pain at the incision site and monitoring for signs of infection. The surgical incisions in the groin and abdominal areas are closed in layers to promote optimal healing. Patients may be advised on activity restrictions to ensure proper recovery and minimize the risk of complications. Follow-up appointments are essential to assess the surgical site and discuss the results of the pathological evaluation of the excised lymph nodes.

Short Descr REMOVE GROIN LYMPH NODES
Medium Descr INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX
Long Descr Inguinofemoral lymphadenectomy, superficial, including Cloquet's node (separate procedure)
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE 1
CCS Clinical Classification 67 - Other therapeutic procedures, hemic and lymphatic system

This is a primary code that can be used with these additional add-on codes.

38900 Addon Code MPFS Status: Active Code APC N ASC N1 Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
RT Right side (used to identify procedures performed on the right side of the body)
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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2017-01-01 Changed Long description changed.
Pre-1990 Added Code added.
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